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2007 Year 4 Issue
- Abstract：Objective To explore the scan technique and image quality of coronary angiography with dual source computed tomography（CT） without oral metoprolol preparation.Methods Plain and enhanced dual source CT coronary angiography without oral metoprolol preparation was prospectively performed in 600 patients.Calcium scoring with plain scan images as well as multi-planar reconstruction（MPR）,maximum intensity projection（MIP）,and volume rendering technique（VRT） reconstruction with enhanced scan images were performed in all cases.The scan technique and post-reconstruction experience was summarized.The image quality was classified as 1 to 4 points,and coronary segments classified according to the American Heart Association standards were evaluated.Results The average calcium score of the 600 cases was 213.6±298.7（0-3 216.5）.The average heart rate of the enhanced scan was 82.1±16.2（47-139） bpm.The post-reconstruction methods with which coronary segments could be shown as best as possible consisted of single phase reconstruction method,two or more phases supplemented method,and electrocardiogram editing method.Altogether 8 457 coronary segments were evaluated,among which 97.2% were evaluated as point 1,1.7% point 2,0.5% point 3,and 0.6% point 4.The coronary segments in 261 cases were completely normal,while 360 segments were diagnosed with <50% stenosis and 625 segments with ≥50% stenosis.Conclusions Excellent coronary artery image can be obtained with dual source CT in patients with any heart rate without oral metoprolol preparation.Heart rate is not a major source of the artifact,coronary segments can be well shown with single or multiple-phase reconstruction method.4|28|5Updated：2024-04-10
- Abstract：Objective To determine the risk of noncardiac surgery in patients with hypertrophic cardiomyopathy.Methods We reviewed the medical records of all patients who were diagnosed as hypertrophic cardiomyopathy at Peking Union Medical College Hospital from January 1998 to August 2006 and identified 24 patients who subsequently underwent noncardiac surgery.Results There were no intraoperative cardiac events.Postoperative cardiac events were identified in 3 patients including 1 death due to acute myocardial infarction and 2 episodes of transient hypotension.Conclusions The risk of anesthesia and noncardiac surgery is low in patients with hypertrophic cardiomyopathy.During the perioperative period,beta-blockers and/or calcium channel blockers should be given;vasodilator and inotropic agents should be avoided due to the side effects on hemodynamics.4|38|3Updated：2024-04-10
- Abstract：Objective To investigate the levels of cardiovascular disease risk factors and their relations to clinical phenotype associated with coronary artery disease（CAD）.Methods The subjects were recruited from five independent cardiovascular centers.Coronary angiography was employed to define the CAD with stenosis in each major vessel ≥70% and control with stenosis <10% in every lesion.The classic risk factors including family history,body mass index,smoking habits,hypertension,diabetes mellitus,and serum lipid levels were surveyed according to established criteria.Associations between risk levels and clinical phenotypes were assessed by case control and correlation analysis.Results A total of 762 individuals were collected,including 481 men and 281 women,aged from 17 to 81（mean 60±10） years.The patients with CAD accounted for 55.5% of all participants,and controls 44.5%,respectively.Compared with the pattern in published data,our study showed that mean serum high density lipoprotein cholesterol（HDL-C） level was significantly lower（P<0.001） and triglycerides was significantly higher（P<0.001）,while total cholesterol（TC） and low density lipoprotein cholesterol levels were comparative（both P>0.05）.The prevalence of low HDL-C（<40 g/L） and hypertriglyceridemia（>150 g/L） were 27.2% and 41.4%,respectively.Mean serum levels of HDL-C and apolipoprotein A1 were significantly higher in female subjects than in male（P<0.001）.Lower HDL-C functioned as an independent risk factor for CAD only in men（RR=2.8,95%CI:1.5-4.2,P<0.001）,yet increased non-HDL cholesterol combined with diabetes mellitus and obesity seemed to play a key role in the development ofCAD in women.Similarity in risk association with CAD was found for hypertension and TC/HDL ratio in male and female subjects,while family history had no relationship with the presence of CAD.Conclusion It is remarkable that emphasis of intervention in future should be given on the prevalent low serum HDL-C and its strong risk correlation with the presence of CAD in male subjects of Chinese Han population.4|28|2Updated：2024-04-10
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EFFECT OF AROTINOLOL ON LEFT VENTRICULAR FUNCTION IN PATIENTS WITH IDIOPATHIC DILATED CARDIOMYOPATHY
Abstract：Objective To evaluate the efficacy and safety of long-term treatment with arotinolol in patients with idiopathic dilated cardiomyopathy（IDCM）.Methods Sixty-three patients with IDCM were evaluated at baseline and after 12-month therapy with arotinolol.The conventional therapy for congestive heart failure was continued throughout the study with arotinolol as the only β-blocker.Left ventricular function was assessed with the New York Heart Association functional class and two-dimensional echocardiography.Results After 12-month arotinolol treatment,there was a significant improvement in left ventricular systolic function.Left ventricular end-systolic dimension significantly decreased from 59.52±8.83 mm to 50.89±8.17 mm（P<0.001）.Left ventricular ejection fraction significantly increased from 27.39%±7.94% to 41.13%±9.45%（P<0.001）.Left ventricular mass index decreased from 150.47±42.42 g/m2 to 141.58±34.36 g/m2（P<0.01）.No adverse events leading to premature discontinuation of study drug occurred.Conclusion In this preliminary study,12-month arotinolol treatment has a favorable effect on left ventricular function in patients with IDCM,and it is safe and well tolerated.4|22|3Updated：2024-04-10 - Abstract：Objective To explore the infarct sites in patients with inferior wall acute myocardial infarction（AMI） concomitant with ST segment elevation in leads V1-V3 and leads V3R-V5R.Methods Five patients diagnosed as inferior,right ventricular,and anteroseptal walls AMI at admission were enrolled.Electrocardiographic data and results of isotope 99mTc-methoxyisobutylisonitrile（MIBI） myocardial perfusion imaging and coronary angiography（CAG） were analyzed.Results Electrocardiogram showed that ST segment significantly elevated in standard leads II,III,aVF,and leads V1-V3,V3R-V5R in all five patients.The magnitude of ST segment elevation was maximal in lead V1 and decreased gradually from lead V1 to V3 and from lead V1 to V3R-V5R.There was isotope 99mTc-MIBI myocardial perfusion imaging defect in inferior and basal inferior-septal walls.CAG showed that right coronary artery was infarct-related artery.Conclusions The diagnostic criteria for basal inferior-septal wall AMI can be formulated as follows:（1） ST segment elevates≥2 mm in lead V1 in the clinical setting of inferior wall AMI;（2） the magnitude of ST segment elevation is the tallest in lead V1 and decreases gradually from lead V1 to V3 and from lead V1 to V3R-V5R.With two conditions above,the basal inferior-septal wall AMI should be diagnosed.4|11|0Updated：2024-04-10
- Abstract：Objective To investigate vascular endothelial growth factor（VEGF） and its signaling pathway spontaneous response in type 2 diabetes mellitus（T2DM） mice to surgery-induced hind-limb ischemia.Methods Sixty mice were randomly divided into two groups,one was fed with normal chow as control,and another was fed with high fat diet to induce T2DM.Fourteen weeks later,mice were surgically induced to hind-limb ischemia.Blood flow restoration was monitored with laser Doppler perfusion imaging.Tibialis anterior muscle was collected after 3 days of hind-limb ischemia.VEGF mRNA and protein expressions were analyzed using real-time PCR and ELISA;expressions of VEGF downstream signal molecules and receptors were analyzed using Western blotting and RT-PCR,respectively.Results Perfusion recovery 10,20,30 days after ischemia was significantly attenuated in T2DM compared with control group（P<0.05）.T2DM impaired VEGF signaling pathway although VEGF levels increased in T2DM group.After ischemia,T2DM group had a comparable increase in VEGF expression compared with control group,but still had an impaired VEGF signaling pathway.Conclusion VEGF signaling pathway is abnormal in T2DM mice,although VEGF had a response to the ischemic stimulation.4|21|2Updated：2024-04-10
- Abstract：Objective To quantitatively evaluate the metabolic changes of benign prostatic hyperplasia（BPH） and prostate cancer in the transitional zone using magnetic resonance spectroscopic imaging（MRSI）,and to analyze the characteristics and differences of the spectra in this zonal area.Methods Eighteen patients with prostate cancer in the transitional zone underwent magnetic resonance imaging（MRI）/MRSI examinations.The（Choline+Creatine）/Citrate（CC/Ci） ratio and the Choline/Creatine（Cho/Cr） ratio were evaluated in each voxel with cancer or BPH confirmed by pathological results.Discriminant analysis was used to determine the power of the two ratios in differentiation between cancer and BPH.Results The CC/Ci ratio and Cho/Cr ratio for cancer voxels were significantly higher than those in the voxels with BPH in the transitional zone（CC/Ci:2.36±1.31 vs.0.85±0.29,P<0.01;Cho/Cr:4.14±1.79 vs.1.26±0.45,P<0.01）.As for the discriminant function with the CC/Ci ratio and the Cho/Cr ratio,the specificity,sensitivity,and accuracy were 98.6%,85.7%,92.9% respectively for the differentiation between cancer and BPH.Conclusions The prostate cancer is characterized by higher CC/Ci ratio and Cho/Cr ratio compared to BPH in the transitional zone.Both CC/Ci ratio and Cho/Cr ratio have high specificity,sensitivity,and accuracy in their discriminative power between cancer and BPH in this zonal area.4|29|3Updated：2024-04-10
- Abstract：Objective To investigate the role of transforming growth factor-β1（TGF-β1）/Smad4 pathway in development of renal fibrosis in streptozotocin（STZ）-induced diabetic nephropathy（DN） rats and explore its possible mechanism.Methods Male Wistar rats weighing 180-220 g were divided into 5 groups:group A（normal control）,group B [diabetes mellitus（DM） 2 weeks],group C（DM 4 weeks）,group D（DM 8 weeks）,and group E（DM 16 weeks）.Except for the normal control group,other groups were induced DM by single injection of STZ（55 mg/kg） respectively.Blood glucose level,serum creatinine,and 24-hour urine protein were examined.Expressions of TGF-β1 and Smad4 protein and mRNA in kidney were detected using immunohistochemical technique,Western blot,and real-time PCR.mRNA expressions of stromelysin-1（MMP-3）,tissue inhibitor of metalloproteinase-1（TIMP-1）,and collagen Ⅲ in kidney were also detected by real-time PCR..Results The levels of blood glucose,serum creatinine,and 24-hour urine protein in rats of group B,C,D,and E were higher than those of the control group.With the progression of renal fibrosis,the expressions of TGF-β1 and Smad4 protein and mRNA in kidney of diabetic rats elevated.In addition,the renal MMP-3 mRNA expression diminished in diabetic rats,while TIMP-1 and collagen Ⅲ mRNA increased.Conclusions In STZ-induced diabetic rats,the TGF-β1/Smad4 appears to play an important role in renal fibrosis of DN.The increased expression of TGF-β1 and Smad4 might result in the transcriptional regulation of downstream target genes of TGF-β1/Smad4 pathway,which contributes to the progression of renal fibrosis in diabetic rats.4|46|32Updated：2024-04-10
- Abstract：Objective To assess the sensitivity,specificity,and feasibility of 4 recombinant Treponema pallidum antigen-based rapid tests in the diagnosis of syphilis.Methods A total of 970 outpatients were selected from the Sexually Transmitted Diseases Centre of Peking Union Medical College Hospital.Venous blood was collected and serum was extracted.T.pallidum antibodies in whole blood,anticoagulant whole blood,and serum were detected using 4 recombinant T.pallidum antigen-based rapid tests.T.pallidum haemagglutination test（TPHA） was considered as the gold standard for the detection of T.pallidum specific antibodies in serum.The sensitivities and specificities of four methods were analyzed.Results The sensitivities and specificities of Abbott Determine Syphilis TP test,SD-BIOLINE Syphilis 3.0 test,VISITECT-SYPHILIS test,and Syphicheck-WB test for serum specimens were 100% and 98.9%,95.7% and 98.0%,94.6% and 98.2%,68.1% and 98.9%;for whole blood were 74.1% and 99.5%,87.9% and 99.4%,73.2% and 99.7%,64.7% and 99.7%.The observed sensitivities of the 4 rapid diagnosis tests were not significantly different with TPHA（P>0.05）.Conclusions The 4 rapid tests show good performance and characteristics in the diagnosis of syphilis.Furthermore,they are more sensitive for serum specimens than whole blood.4|40|2Updated：2024-04-10
- Abstract：Many studies on oxidative stress,insulin resistance,and antioxidant treatment have shown that increased oxidative stress may accelerate the development of diabetic complications through the excessive glucose and free fatty acids metabolism in diabetic and insulin-resistant states.Many pathogenic mechanisms such as insulin receptor substrate phosphorylation are involved in insulin resistance induced by oxidative stress.And antioxidant treatments can show benefits in animal models of diabetes mellitus and insulin resistance.However,negative evidence from large clinical trials suggests that new and more powerful antioxidants need to be studied to demonstrate whether antioxidants can be effective in treating diabetic complications.Furthermore,it appears that oxidative stress is only one of the factors contributing to diabetic complications.Thus,antioxidant treatment would most likely be more effective if it were coupled with other treatments for diabetic complications.4|33|11Updated：2024-04-10
- Abstract：<正>PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are4|10|0Updated：2024-04-10
- Abstract：<正>Growth associated protein-43（GAP-43） is considered to be one of the most useful molecular markers for the neural development,nerve regeneration,and neuroplasticity4|19|1Updated：2024-04-10
- Abstract：<正>Acute myocardial infarction Inferior-septal Myocardial Infarction Misdiagnosed as Anterior-septal Myocardial Infarction:Electrocardiographic,Scintigraphic,and Angiographic Correlations4|14|0Updated：2024-04-10
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